Code of Conduct

Specialty drug pharmacies offer a wide range of value-added services to support patients who have been prescribed specialty drugs in Quebec, at no additional cost. Specialty drugs, as referenced in this Code, are complex, high-cost medications used to treat rare, chronic or complex diseases that require special pharmaceutical care and services.

Specialty drug pharmacies play a key role in Quebec's pharmacy landscape, and their contribution is essential to patient care and to the healthcare system.

Specialty drug pharmacies have adapted their practices to better support patients who use specialty drugs in Quebec. Specialty drug pharmacies:

1. 1. make significant investments in the facilities and staff required to manage an inventory of complex and costly drugs and provide personalized support services to patients;
   2. supervise treatment management to optimize patient outcomes through sustained clinical follow-ups;
   3. facilitate the reimbursement process with insurers and offer patients solutions to reduce any financial burden associated with the cost of specialty drugs, thus promoting rapid access to treatment;
   4. manage services related to the dispensing and delivery of specialty drugs according to rigorous, standardized season-appropriate processes and, when required, ensure the maintenance of the cold chain to protect the integrity of the medicine; and
   5. coordinate the intravenous infusion services required for specialty drug administration, when applicable.

This Code applies to the pharmacies that are members of the Regroupement des pharmacies de médicaments de spécialité du Québec (the “Members”) and their employees, including pharmacy owners and their staff. Compliance with this Code is a condition to be and remain a Member of the Regroupement.

The following terms used in this Code have the meanings assigned to them below:

1. 1. "Code" means this Code of Conduct of the Regroupement des pharmacies de médicaments de spécialité du Québec;
   2. "Specialty Drugs" has the meaning ascribed to it in section 1 above;
   3. "Member" means any specialty drug pharmacy that has duly joined the Regroupement des pharmacies de médicaments de spécialité du Québec;
   4. "Specialty Drug Pharmacy" means a pharmacy that has developed expertise in the management and dispensing of specialty drugs, in addition to the personalized therapeutic monitoring of patients who use them;
   5. "Program" or "Patient Support Program" means any patient support program described in Section IV of the Code;
   6. "Regroupement" means the Regroupement des pharmacies de médicaments de spécialité du Québec.

In this Code, the singular includes the plural and vice versa.

The mission of the Regroupement and its Members is to raise awareness of the practice of specialty drug pharmacy and to promote best practices for the benefit of patients in Québec.

The vision of the Regroupement and its Members is to ensure the harmonized practice of specialty drug pharmacy in collaboration with the various healthcare providers, in order to optimize the well-being of patients while respecting their choices and needs.

1. Access to speciality drugs in the best interests of the patient — In addition to having the appropriate infrastructure, facilities, professional resources and operating procedures for the optimal practice of specialty drug pharmacy, Members must uphold best practices in the management of patients requiring specialty drugs that allow optimized access to specialty drugs, adherence to treatment and desired therapeutic outcomes. Members must always act with the best interests of the patient in mind.
2. Clear and simple communications — Members must communicate, in simple and clear terms that are easy for patients to understand, all aspects of their treatment and the expected effects.
3. Patient freedom of choice — Members must respect individual patients’ freedom to consult the pharmacist of their choice for the dispensing and monitoring of a speciality drug and, where appropriate, to call on the services of another pharmacist or healthcare professional in connection with their treatment. Members recognize patients’ right to obtain all relevant information to exercise this choice in full knowledge of the facts. Members must validate a new patient's consent to receive professional services from their specialty drug pharmacy when initiating the first treatment and remind patients of their right to obtain the medication from their community pharmacy or any other pharmacy.
4. Interprofessional collaboration — Members must leverage interprofessional collaboration to ensure that patients receive the appropriate care and collaborate with other pharmacists or healthcare professionals to address patients’ needs.
5. Professional independence — Members must maintain their professional independence at all times. They must carry out their activities with integrity, objectivity and autonomy and are free to make decisions related to their professional duties on the basis of their own judgment, ethics and competence, without being subject to external pressure resulting, for example, from conflicts of interest or financial ties. Members must take all reasonable steps to avoid any situation of conflict of interest and must refrain from soliciting any advantage, financial or other, from a third party to avoid any situation in which they would be indebted to that third party in a way that would call into question their professional independence.
6. Integrity — Members must act in good faith and with professionalism, diligence and integrity towards their patients, colleagues and other professionals with whom they collaborate in the provision of professional services.
7. Respect for professional secrecy and protection of personal information — Members must maintain the confidentiality of patient information. They must comply with the laws and regulations for the protection of patients' personal information and implement the necessary measures to uphold this commitment.

Expertise and continuing education — Members must ensure that their employees pursue ongoing training to keep abreast of the latest advances in pharmaceutical services for specialty drugs and interprofessional collaboration.

Patient Support Programs put in place by specialty drug manufacturers offer patients services to facilitate access to their medicine, optimize their treatment and, in some cases, enable them to obtain financial support. These programs also aim to ensure compliance with treatment protocols and strict storage conditions to which these medicines are subject, and to monitor and manage any related potential adverse effects.

Members may collaborate with a Patient Support Program that complies with Members’ professional obligations and the principles set out in this Code. Members commit to take all reasonable measures to ensure that patients have the option to receive their specialty drug from their pharmacy of choice, and that they have access to the relevant information to make an informed decision on the matter.

Members and its employees must respect laws and regulations relating to the practice of their profession at all times.

Compliance

Members agree to comply with the provisions of this Code. Each Member must designate a representative responsible for ensuring this commitment, for ensuring that its employees receive training on the Code and for implementing with due diligence the appropriate measures to ensure compliance. Members must report annually to the Regroupement Board of Directors on the measures implemented in this respect.

Complaints

1. Anyone may file a complaint against a Member, or an officer, or a Member’s employee regarding a violation of this Code. The complaint must be filed in writing with the Regroupement Board of Directors.
2. The complaint must be handled within 90 days of receipt, after the party concerned has been given the opportunity to make written observations on the complaint.
3. The Regroupement Board of Directors, excluding, where applicable, the Member who is the subject of the complaint, must render a decision on the complaint. A complaint deemed inadmissible will be rejected and the decision justified in writing. A complaint deemed valid will be the subject of a written decision with reasons. The decision will be sent to the parties concerned no later than 30 days after it is rendered.
4. In the event a breach to this Code is confirmed, the Member agrees to take the necessary measures identified by the Regroupement Board of Directors to rectify the situation. Additional measures may be enforced if the situation is not rectified within the required timeframe and under the conditions determined by the Regroupement Board of Directors. In the event of repeated breaches of the provisions of the Code or failure to comply with the measures identified by the Regroupement Board of Directors, the Board may dismiss the Member.